Legs Matter’s position on harm

Our focus on harm

Insufficient action on leg and foot conditions is harming people. The current reality in the UK is that people with leg and foot conditions are not being treated adequately or in time and, as a result, are being harmed. Harm includes unnecessary pain, infection, amputation, hospitalisation, loss of livelihood, social isolation, anxiety, and depression. This harm is unacceptable and avoidable. We are calling on senior leaders and decision makers within the NHS to radically rethink the way leg and foot conditions are managed in order to reduce harm.

What is harm?

The most fundamental principle of any health care service is to “do no harm”^[1]. Preventing and reducing the risks of harm means providing patients with a “safe and effective environment” ^[2]. Harm from leg ulceration, foot ulcers and swelling is caused by delayed, inadequate or incorrect care.

This can include:

• Delayed or inadequate assessment and referrals
• Absent, delayed or inaccurate diagnosis
• Lack of evidence-based care
• Inappropriate dressing management, resulting in increased risk of infection and increased risk of attendance at A&E
• No or sub-optimal compression, offloading or pressure redistribution
• Lack of personalised care planning, including a patient not being given flexibility or choice about their appointments and treatment

The solution

The responsibility for reducing harm should not just sit with the clinicians who provide direct patient care. We are calling on senior leaders and decision makers within the NHS to recognise harm and to prioritise service change. This includes:

• Recognising insufficient action on leg and foot conditions as harm and recording this on the risk register
• Prioritising system-wide change to prevent people with leg and foot conditions being harmed
• Putting in place new leg and foot service models informed by national evidence-based recommendations
• Developing services in partnership with patients and their lived experience
• Making sure the whole workforce has the appropriate skills and knowledge to manage leg and foot conditions today and in the future

[1] World Health Organisation, Patient Safety, web page

[2] NHS England, Patient Safety, web page